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Initial assessment (for soccorista)
---- This article needs work: Specifically, it may contain irrelevant information, or may not be entirely appropriate to the medical realities of the soccoristas who will use it as a learning supplement. Feel free to edit as you translate. ---- La evaluación inicial es una manera organizada de reconocer y responder a emergencias que amenazan la vida en una crisis. Puede tomar desde unos cuantos segundos hasta un minuto, y despues usted se quedará con el herido o lesionado hasta que llegue ayuda avanzada, o hasta que la persona y usted decidan que está bien que usted se vaya. Respire hondo Imagine que uno de sus amigos se lesiona o se enferma de repente. O quizá usted es el primero en encontrar a una persona desmayada en una manifestación. ¿Qué hará? ¡Bueno, no tenga miedo! Respire hondo y piense. Inspección de la escena Antes de acercarse, inspeccione la escena: *¿Es segura? *¿Cuanta gente necesita ayuda? *¿Es peligroso? observe cosas como: **Fuego **Escombros cayendo **Estructura inestable ** Policía avanzando **Multitud fuera de control **Trafico *¿Cómo se acercará y cómo permanecerá seguro? Elimine o preparese para daños potenciales para el enfermo o lesionado, para usted y para los testigos. ¡Trate de que lo que sea que le haya pasado a su amigo o camarada no le pase a usted también! Use a la multitud para mover obstáculos, dirigir el tráfico, ir por ayuda, y tener un espacio seguro alrededor de la gente lastimada. Trate de hablar en una voz calmada para ayudar a que los demás estén calmados. Recuerde, la gran mayoría de la gente quiere ayudar. Preséntese *"Hola, soy fulano-de-tal. Sé algo de primeros auxilios. Determine si la persona está alerta *"¿Está usted bien?" *"¿Cuál es su nombre?" *"¿Sabe usted donde está? /¿Qué día es? /¿Qué pasó?" Si la persona no responde a la conversación normal, grítele y de golpecitos en el hombro-- pero no agite a la persona, esto podría empeorar una lesión espinal o de cuello. Consiga el consentimiento Descubra si la persona va a aceptar su cuidado. Si ellos no quieren hablar o ser tocados por usted, o lo que sea, haga un esfuerzo para saber por qué y consiga alguna ayuda que ellos acepten. Lo que usted descubra en la primera parte de la evaluación inicial afecta sus acciones en la segunda parte. Cuando usted haya inspeccionado la escena haya determinado que la persona está alerta, usted probablemente se dará una idea del mecanismo de lesión o enfermedad (MDL), que es una palabra rimbombante para denominar a la causa del problema. ¿Cree que la persona cayó? ¿la persona estaba en una riña? ¿la persona está borracha? preste atención. Lo más importante que usted se debe preguntar antes de continuar es: Basado en el MDL, ¿sospecha usted una lesión espinal? Lleve a cabo el CAB Esto es una manera de checa las amenazas a la vida potenciales antes de actuar sobre un problema especifico. Desde el 2010, la Asociación Americana del Corazón (AHA, por sus siglas en inglés) hace enfasis en las compresiones toracicas, y ha cambiado el protocolo ABC, por CAB. Siempre evalue y trate los sistemas en su orden de prioridad. C está antes de A... *'C'''ompresiones (''Circulación) *vía Aérea *'B'''uena respiración *'D'iscapacidad *'A'''mbiente C-- Circulación ¿Es necesario dar compresiones? Si la persona le hablo a usted de manera normal, la vía aerea está . Si la persona no habla y parece no respirar, de 30 compresiones presionando fuerte y rápido en el centro del pecho de la víctima. B-- is the person Breathing? If they can talk normally to you, they are breathing, right?If they didn't talk, and there seems to be no airway obstruction, but no breath is coming out or in, the problem might be with their breathing system. C-- is their Circulation compromised? The circulatory system is contained within the heart and blood vessels. If the person is breathing, their heart is beating. Don't waste time taking their pulse unless you know how. *Look for bleeding. Remember that bulky clothing, sand, or rocks might disguise blood loss. Blood loss may also be internal. Even if you find one bleeding injury, keep looking-- there may be other hidden injuries that are more severe. *If they are pale, cool, and clammy, and if they are becoming less alert, consider that they may be entering shock. D-- have they been Disabled? Any person who cannot think, move, or take care of themselves as they normally do-- or any person with a potential spinal injury-- is disabled. *Stay with them until they recover or help arrives. E-- have they suffered / will they suffer Exposure to a dangerous environment? While the environment in which you provide first aid might feel fine to you, pay attention to its effect on the sick or injured person. *Extremes of heat and cold can complicate any first aid, but cold exposure is more dangerous than heat. Any person with serious blood-loss, burns, or any injury that leaves them disabled needs to be kept warm and dry in all but the hottest of weather. Think of other environments which can seriously hurt an injured or sick person. Remember that the purpose of initial assessment is to discover threats to a person's life, and protect against those first, before providing general first aid. Document your care It is a good idea to keep notes about any problems you encounter in your initial assessment. Some medics put strips of duct tape on their pants and keep basic notes on it with permanent marker. They number their patients to maintain patient confidentiality, and take notes like this: :#1 :19yo F w/(L) leg wound :"shot w/tear gas cannister" :A-- ok :B-- ok :C-- ok (minor bleeding (L) lower leg) :: HR elevated w/i normal range :D-- difficulty moving w/o assistance ::Pain 4 (out of 5) with pressure :E-- cold :Plan-- help her move inside warm bar, elevate leg, first aid, get to health center. Many medics write their notes after they have completed initial assessment and basic first aid, so that they can give the person all their attention. Documentation is always important, and becomes more important the more assessment skills you know, and the longer the person will be in your care. Re-assess as needed Signs for some life-threats take a while to show up. Keep an eye on the person while they are in your care. If they can talk, have a conversation. Not only is it good for their morale, but you can quickly assess changes in their level of alertness. If the person's condition appears to change, assess again. Also, if you are going to be with the person a long time, assess them every few minutes, 15 minutes, hour, or few hours, depending on how injured or ill they are. Write down any changes for the better or worse. Notes It can be hard to tell what's wrong. Breathing problems may be due to asthma or anaphylaxis. Confusion could be due to diabetes, dehydration, psychological stress, or a head injury. Act out of respect for anyone who trusts you with their infirmity, and harm no one. This material is intended as a learning supplement. Reading this material is no substitute for first aid / medical training with a qualified trainer. We encourage you to pursue ongoing education, reviewing and upgrading your skills-- for the safety of both yourself and anyone you treat. Category:Articles requested for translation